专科医院内设结核病项目门诊在结核病人发现及管理中作用的探讨  

Investigation on the effect of the detection and management of TB patients by setting up TB clinic project spots in special hospitals

作　　者：王莉丽[1] 王茜[1] 张洁莹[1] 朱桂花[2] 周云[2] 

机构地区：[1]合肥市疾病预防控制中心,安徽合肥23006 [2]安徽省肺科医院,安徽合肥230022

出　　处：《中华疾病控制杂志》2010年第5期429-432,共4页Chinese Journal of Disease Control & Prevention

基　　金：第一轮中国全球基金结核病项目(CHN-102-G01-T-00)

摘　　要：目的探讨专科医院内设结核病项目门诊在发现及管理病人中所发挥的作用。方法收集并分析2005-2009年合肥市疾病预防控制中心登记的肺结核病人资料及在市区省级专科医院所设结核病项目门诊的有关资料,包括人员、设备条件及工作情况等。结果专科医院项目门诊中,共有专、兼职结核病防治人员8人,均有结核分枝杆菌检验人员并可开展痰涂片及分枝杆菌培养工作。自2005-2009年,合肥市区共发现活动性肺结核病人12024例,其中本市病人6638例(菌阳2221例);流动人口病人5386例(菌阳1368例)。市疾病预防控制中心发现登记病人3969例,占总病人数的33.0%,专科医院项目门诊发现登记病人8055例,占67.0%。5年间,共发现菌阳病人3589例,其中60.5%由专科医院项目门诊发现。6169例菌阳病人采取了督导管理,其中41.8%由专科医院项目门诊完成督导。专科医院管理病人完成治疗率与疾病预防控制中心相比有差异。结论在省会城市、居住分散、不方便病人就诊督导治疗地区,在专科医院内设结核病项目门诊能给结核病人的就医带来方便,并有利于结核病人发现和督导治疗。但对项目门诊应加强管理和督导,增加投入,使其成为结防服务体系中的重要组成部分。Objective To investigate the effect of detection and management of tuberculosis patients in TB clinic project spots setting up in the TB special hospitals.Methods From 2005 to 2009,the data of tuberculosis patients registered in Hefei CDC and the relevant information of outpatient clinic of specialist hospitals in the urban areas,were collected and analyzed,including the personnel,equipment conditions and their working status.Results In the anti-tuberculosis spots,there were eight full time or part time anti-TB doctors.All of them can do the sputum smear examination and the sputum culture.From 2005 to 2009,12 024 active lung TB patients were detected in the urban of the Hefei,in which 6 638 local patient cases（2 221 cases were culture positive）,5 386 cases were floating population（1 368 cases were culture positive）.3 969 cases were detected and registered in Hefei CDC,which accounted for 33.0% of the total,and 1 049 cases were detected in TB clinic project spots,which accounted for 67.0%.During the five years 3 589 positive cases were detected,in which 60.5 % were detected in TB clinic project spots.6 169 cases were treated under DOTS（directly observed treatment system）,in which 41.8 % were done in the TB clinic project spots.There were some different effects between the Hefei CDC and TB special hospitals.Conclusions In the provincial capital city,the area where people live dispersing and are not easy to get to see a doctor,setting up TB clinic project spots in hospitals can be convenient for the tuberculosis patients,and will be helpful to detect and treat the patients under DOTS.Nevertheless,we must reinforce the DOTS and put more fund to the TB clinic project spots,and make it as the key part of tuberculosis control.

关 键 词：结核 预防和控制 医院 专科 

分 类 号：R181[医药卫生—流行病学] R521[医药卫生—公共卫生与预防医学]